When Caitlyn Jenner recently visited the Academy for Young Writers, an LGBTI-friendly school in a working-class New York neighbourhood, she was expecting some flak. In particular, from two youngsters, living non-binary lives, who had been vocal in their criticisms of her. Caitlyn was privileged, they said, had made disparaging remarks about “men in dresses”, and had no insight into the intersections of class and race with sexuality and gender. Most damagingly, she voted Republican!

While they were quickly won over by her charm and frank admissions that she’d got a lot wrong in her own trans journey, taking a selfie before she left, others who were responding on Twitter as the meeting was live streamed were not bowled over, to say the least.

“Just watching him talk is nauseating.”
“She is still a HE!!”
“He’s f**kin Ugly!!”
“He is evil.”
“Mental health should be the topic.”

In fact mental health is the topic for this year’s IDAHOT – the International Day Against Homophobia, Transphobia and Biphobia, May 17. While the acronym is taken to include other oppressions against non-conforming people, IDAHOT has stuck as the compromise term in a terrain where letters of the alphabet matter in defining who is centred and who is marginal.

Being deliberately mis-gendered, or deliberately gendered when you prefer to be non-binary or a-gender, is a cruel and unnecessary act, saying so much more about the subjectivity of the speaker than the embodiment of the spoken to. It speaks to fear, anxiety, panic and anger. Even further, there are times when the mental health of the homophobe and the transphobe could be a legitimate subject of concern and enquiry. To express so much hatred and vitriol for someone who threatens your equanimity (and I suppose privilege) – even to the point of acting out violently – suggests all is not well.

But pathologising homo/trans/biphobias echoes, ironically, the attempts to pathologise sexual and gender diversities, and may yet backfire. Most importantly, it frames hostility towards these diversities as a purely individual phenomenon, rather than seeing it as rooted in social processes that reproduce heteropatriarchy, binaries and limiting normativities. This may encourage us to focus on the prejudiced and hateful individual while ignoring the larger culture that stigmatises homosexuality and gender variance, and polices the patriarchal order.

The IDAHOT focus for 2016 on mental health of all people who are marginalised because of their sexuality or gender expression and identity, is a useful moment to ask questions about the “larger culture” that reproduces this marginalisation, and why. It also confronts us with how we are letting sexual and gender minorities down by not recognising and protecting the dignity and equality promised to all in our Constitution.

One aspect of the “larger culture” is the world of professional mental health, which through its need to understand, classify and treat psychological ill health, has the power to decide what is or is not “health”. Homosexuality has been declassified as a mental disorder in many countries (with many exceptions it must be noted) and in many systems of classification – notably the World Health Organisation published on May 17 1990 a revised version of the International Classification of Diseases Manual in which homosexuality was not considered a mental disease any longer. This is the reason why, every year since 2004, the International Day against Homophobia, Transphobia and Biphobia is celebrated worldwide on May 17.

For gender identity, the picture is not as positive. Many mental-health professionals still consider trans identities to be linked to mental disorders. “Gender identity disorder” or equivalent mental-health diagnoses are mandatory in almost all countries for trans people to access gender-affirming treatment and diagnoses and other medical and social preconditions are required to access legal gender recognition. This may contribute to stigma and social exclusion of trans people, which is surely an unintended and undesirable consequence.

Perhaps the most important aspect is that while there is an increasing (albeit slowly) global sense that sexual and gender diversity is not a sign of mental ill health, it is now clear that stigma and discrimination is the major cause of psychological distress to sexual and gender minorities. Inequality, harassment, physical harm, and a lack of legal protection, all promote this distress. And even if one has personally never been called out or physically hurt, the fear of this can increase the chances of staying closeted, itself a potential source of harm.

All these phenomena have been captured in the term minority stress. As bad as this stress is in adults who fall under the LGBTI umbrella (and its related range of identities and practices), it surely causes untold harm to young people who may be more vulnerable, in the broader society of course, but especially in the home and in the school.

Love or hate her, Caitlyn Jenner has been using some of her notoriety to reach out to young people, and those who should care for them, to help them feel less alone, and to lobby for youth-orientated programmes and inclusive school systems. Perhaps this is why those youngsters at the Academy for Young Writers were won over – a trans woman of power and privilege had come down to their level to hear and affirm them. Yes, this may not have changed the system that reproduces the harms these two face, but for a brief moment their equality and dignity were affirmed.

So much more needs to be done: we should all support the depathologisation of trans identities, oppose “conversion” therapies for homosexuality as the psychological abuse they are, and move to realise the promise of our Constitution.

The flippant re-working of the RuPaul maxim in the title of this piece is not meant to dishonour the real struggles that sexual and gender minorities face, but sometimes irony is an appropriate defence against oppression, and the vile comments the haters spew out. It’s a pity that it’s still necessary in 2016.
Pierre Brouard is the deputy director of the Centre for Sexualities, Aids and Gender at the University of Pretoria and a member of the Sexuality and Gender Division of the Psychological Society of South Africa (PsySSA).

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PsySSA, the Psychological Society of South Africa, is the national professional body for psychology. Committed to transforming and developing psychological theory and practice in South Africa, PsySSA strives to serve the needs and interests of a post-apartheid country by advancing psychology as a science, profession and as a means of promoting human well-being. This blog hopes to engage psychologists and citizens in debating issues, from mental health to the socio-political. Visit www.psyssa.com